Renal Flashcards
1
Q
Hemolytic Uremic Syndrome (HUS) (5)
A
Hemolytic anemia
Acute kidney injury (AKI)
Thrombocytopenia
Shiga toxin
E. coli O157
2
Q
Meds witheld with AKI
A
DAMN drugs:
Diuretics and Digoxin
ACEi or ARBs (nephroprotective in CKD) & ABX
Metformin/Methotrexate
NSAIDs
3
Q
AKI stages for creatine
1,2 & 3
A
1.5-1.9 increase in creatinine → AKI Stage 1
2.0–2.9x increase in creatinine → AKI Stage 2
3x increase in creatinine or more → AKI Stage 3.
current creatinine / baseline creatinine
4
Q
Definition and Staging AKI (KDIGO Criteria)
Stage 1,2 & 3
Urine Output Criteria
A
✅ Stage 1: Oliguria for >6 hours
✅ Stage 2: Oliguria for >12 hours
✅ Stage 3: Severe oliguria (>24 hours) or anuria (no urine) for ≥12 hours
5
Q
Causes of AKI Pre Renal (3)
A
(DSH)
dehydration
sepsis
heart failure
6
Q
Causes of AKI (intrinsic) Renal (3)
A
acute tubular necrosis
glomerulonephritis
nephrotoxins like NSAIDs or ACE inhibitors
i.e. direct kidney damage
7
Q
Causes of AKI Post-renal
I.e. obstruction
(3)
A
kidney stones
enlarged prostate
tumors
8
Q
Key test to rule out obstruction
A
USS KUB
(post-renal AKI)
9
Q
Diagnostic criteria in AKI
A
↑ in Creatinine ≥ 50% in 7 days
10
Q
Key Mx in AKI (DAMN + other)
A
Stop DAMN drugs:
Diuretics and Digoxin
ACEi or ARBs
Metformin or Methotrexate
NSAIDs
&
give Fluid rehydration
11
Q
CKD, how long does to qualify?
A
> 3 months
12
Q
eGFR diagnosis for CKD stage 4 & 5
A
13
Q
ACR diagnosis for CKD
A
ACR ≥3 mg/mmol
14
Q
G1 (eGFR ≥90) means?
A
evidence of kidney damage, even though the filtration rate is still normal
15
Q
G5: eGFR <15 means?
A
(End-Stage Renal Disease - ESRD).
16
Q
Px with eGFR < 30 , next step?
A
accelerated referral progression
17
Q
ACR ≥ 70 means?
A
Uncontrolled Hypertension
18
Q
1st Line Tx BP if ACR >30?
A
ACE/ ARB (ARB if black)
19
Q
Cause of Anameia
A
Low Erythropoietin
Ferrous sulfate
20
Q
Indic for URGENT Acute Dialysis (5)
A
AEIOU
Acidosis
Electrolytes
Intoxication
Oedema
Uraemia Symptoms
21
Q
Stage req. for Long term dialysis
A
CKD Stage 5
22
Q
catheter name in peritoneal dialysis?
A
Tenckhoff
23
Q
options for Haemodyalysis (2)
A
Tunnelled cuffed catheter (immediate)
Arterio-venous fistula
24
Q
What is the first-line choice for an AV fistula?
A
Radio-Cephalic (Wrist Fistula)
25
Complications of AV Fistula (3)
Thrombosis
Stenosis
Steal Syndrome
26
Usual Renal immunosuppressants (3)
Tacrolimus
Mycophenolate
Pred
27
2 cancers caused by immunosuppressants
Skin (SSC)
NHL
28
Types of Glomerulonephritis
(2)
Nephritic Syndrome
Nephrotic Syndrome
29
Nephritic Syndrome (3)
hematuria
mild to moderate proteinuria
hypertension
30
Nephrotic Syndrome (4)
heavy proteinuria (>3.5 g/day)
hypoalbuminemia
oedema
hyperlipidemia.
31
IgA Nephropathy (Berger’s Disease) Sx (2)
episodic hematuria
respiratory infection
32
IgA Nephropathy (Berger’s Disease) Ix, finding
Diagnosis: IgA deposits on kidney biopsy.
33
IgA Nephropathy (Berger’s Disease) Mx (3)
ACE inhibitors
ARBs for proteinuria,
possibly corticosteroids
34
Membranous Nephropathy causes what?
causes nephrotic syndrome in adults
35
Membranous Nephropathy secondary//
memranous glomerulonephritis? Ax (3)
Hepatitis B
malignancy
autoimmune diseases (SLE)
36
Membranous Nephropathy which deposits
IgG and Complement deposits on membrane
37
Which Autoantibodies against glomerular basement membrane, which disease
Exposure to solvents
Anti-GBM Disease (Goodpasture’s)
38
Goodpasture Syndrome (3)
Pulmonary issues
Haemoptysis
Anti-GBM Antibodies
39
Post-Streptococcal Glomerulonephritis (PSGN) (3)
Cola-colored urine (hematuria).
Immune complex deposition
(subepithelial humps/bumps).
Recent streptococcal infection (e.g., throat or skin infection) (2 weeks)
40
Fever
Rash
Mild Oema
NSAIDS
High BP+ Eosiphillia
Dx and Big buzzword?
Acute Interstitial Nephritis (AIN)
White cell casts
41
Whats is ↑ in AIN
↑ Creatine
↑ Eosinophils
42
Triad of features AIN
Triad of
Fever
Rash
Eosinophilia
43
Diagnostic test for AIN
Kidney Biopsy for Histology
44
Mx for AIN (2)
Stop using trigger
Steroids
45
common cause of intrisic renal Acute Kidney Injury (AKI)
Acute Tubular Necrosis
46
What dies in ATN
tubular epithelial cells within the renal tubules
47
Ischemic ATN Ax (3)
Shock/Sepsis
hypotension/ hypovolemia
Deyhdration
48
Nephrotoxic ATN drugs (3)
Aminoglycosides
NSAIDs
contrast agents
49
ATN Urinalysis (1)
Muddy brown granular casts (sloughed tubular cells)
50
ATN bloods (3)
↑ creatinine
↑ blood urea nitrogen (BUN).
↑ FeNa (>2%) =ATN
FeNa <1% = pre-renal AKI
51
ATN Tx (2)
Stop nephrotoxic meds
IV fluids
52
Renal Tubular Acidosis Type 2 (proximal RTA) is a disorder where the kidneys can't properly reabsorb XXX in the proximal tubule, leading to YYY.
What is XXX and YYY
XXX= Bicarbonate
YYY= Metabolic Acidosis
53
Main cause of Renal Tubular Acidosis Type 2
Fanconi's syndrome
54
Renal Tubular Acidosis Type 2 Tx
Oral Bicarbonate
55
What causes Acidosis in:
RTA T1
RTA T2
RTA T4
RTA T1= Unable to excrete Hydrogen Ions
RTA T2= Unable to reabsorb Bicarbonate
RTA T4= Reduced action Aldosterone
56
Renal tubular acidosis type 1 key disease linked?
Sjögren's syndrome (Dry Eyes, and Dry Mouth)
57
Renal tubular acidosis type 1
Affected Tubule?
K+ ↑ ↓ ?
Urine PH ↑ ↓ ?
bonus buzzword?
Distal
K+ ↓
Urine PH ↑
Kidney stones
58
Renal tubular acidosis type 2
Affected Tubule?
K+ ↑ ↓ ?
Urine PH ↑ ↓ ?
Proximal
K+ ↓
Urine PH ↑
59
Renal tubular acidosis type 4
Affected Tubule?
K+ ↑ ↓ ?
Urine PH ↑ ↓ ↔ ?
Distal
K+ ↑
Urine PH ↔
60
Hemolytic Uremic Syndrome (HUS)
(3)
Hemolytic Anemia (MAHA)/schistocytes
Thrombocytopenia
Acute Kidney Injury (AKI): ↑ creatinine levels
61
Toxin related to HUS
Shiga
62
Shiga comes from which bacteria (2)
E.Coli 0157 (main)
Shigella
63
HUS Tx (3)
Antihypertensive meds
Blood transfusion
Dialysis
64
2 key buzzwords for HUS
PEADS
Petting zoo/animal contact
Child
65
Who usually gets Rhabdomyolysis
elderly people with fall
66
Muscle breakdown products (4)
Myoglobin
K+
PO₄³⁻
CK
67
Out of the muscle breakdown products, which are most harmful to kidneys
Myoglobin
68
Urine colour in Rhabdomyolysis
Red-Brown
69
Why is Urine colour red brown?
Myoglobinuria
70
Rhabdomyolysis key Dx
CK
71
Rhabdomyolysis Tx
IV fluids
72
Hyperkalemia ECG (3)
Flattened P waves
Broad QRS
Tall tented T waves
73
What meds cause Hyperkalemia (4)
Spirolactone Aldosterone Antagonists
ACEi
ARBs
NSAIDs
74
What commonly causes a false result in Hyperkalemia?
Hemolysis while taking the sample
75
What needs monitoring in Hyperkalemia (1)
ECG changes
76
Hyperkalemia Tx (elctrolyte imbalance)
Insulin + Dextrose Infusion
77
Hyperkalemia Tx (stabilise heart)
COMES FIRST
IV Calcium Gluconate
78
Polycystic Kidney Disease (3)
Cysts (in kidneys and sometimes liver)
Hypertension (common early sign, especially in ADPKD)
Autosomal Dominant (for ADPKD; Autosomal Recessive for ARPKD)
79
PKD inheritance pattern?
Autosomal Dominant
80
PKD Ix
USS
81
PKD findings in:
Brain?
Colon?
Heart?
Brain= Cerebral Aneurysms (Subarachnoid haemorrhage)
Colon= Diverticula
Heart= Valve Disease (Mitral Regurg) mitral valve prolaspe
82
Cause of Hematuria in PKD
Cyst Rupture
83
Meds to slow down PKD
Tovaptan
84
nephrotic syndrome (3)
proteinuria (>3-3.5g/day)
oedema
hypoalbuminaemia
hyperlipidaemia
lipiduria
85
Nephritic Syndrome (5)
Hematuria (cola-colored or smoky urine)
Hypertension (due to fluid retention)
Oliguria (reduced urine output)
Proteinuria (mild to moderate)
Red blood cell casts (in urine microscopy)
86
Nephritic Syndrome, who usually gets it?
Children and Young Adults: Often post-infectious (e.g., post-streptococcal glomerulonephritis).
Middle-aged adults: Conditions like IgA nephropathy or lupus nephritis can present in young to middle-aged adults.
87
Post-Streptococcal Glomerulonephritis , who usually gets it and why?
Child (often 5–12 years old) with recent history of a sore throat or skin infection (e.g., impetigo).
88
IgA Nephropathy, who usually gets it and why?
Young adult with recurrent episodes of hematuria, often following an upper respiratory infection.
89
Lupus Nephritis, who usually gets it and why?
Young female adult with systemic lupus erythematosus (SLE)
90
the most common cause of nephrotic syndrome in children?
Minimal Change Disease
91
Focal Segmental Glomerulosclerosis (FSGS) (3)
NEPHROTIC!
✅ Segmental sclerosis on biopsy
→ Only some glomeruli affected (focal), and only parts of each glomerulus (segmental)- HYALINOSIS
✅ Can be primary or secondary
→ Secondary causes = HIV, obesity, heroin use, sickle cell disease
✅ Common cause of nephrotic syndrome in adults
→ Especially in Black patients and those with HIV
92
** NEPHRITIC NEPHROTIC MIXED!
**
Membrano**proliferative** Glomerulonephritis (MPGN)
Mesangiocapillary glomerulonephritis
T1 And T2
(3 EACH)
T1 MPGN
Double-contour ("tram-track") appearance
Low C3/ Low C4
Hep B/ C
Adults
IgG deposits
====================
T2 MPGN
Dense deposits (DISEASE NAME ALSO)
Low **C3b**/ High C4
USUALLY KID
93
Minimal Change Disease (MCD)
(3)
odocyte foot process effacement
Selective proteinuria
Responds to steroids
94
Diabetic Nephropathy (3)
Kimmelstiel-Wilson nodules
Hyperfiltration injury
Mesangial expansion
95
**Same name lol**
Membranous nephropathy (MN- MOST COMMON) ✅
Membranous glomerulonephritis (MGN) ✅
Membranous glomerulopathy ✅
**NEPHROTIC**
Subepithelial deposits
"Spike and dome" appearance
PLA2R antibodies
Thickened basement membrane
Hep B
MOST COMMON FOR ADULTS
Tx ACEi Arb
96
IgA Nephropathy (Berger's Disease) (3)
Mesangial IgA deposits
Recurrent hematuria
After respiratory infection
97
Nephrotic Syndrome Buzzwords (3)
Massive proteinuria (>3.5 g/day)
Hypoalbuminemia
Edema
98
Nephritic Syndrome (3) Buzzwords
Hematuria (red cell casts)
Hypertension
Mild to moderate proteinuria
99
alport (3)
eye
ear
urine
affected
can't pee, can't see, can't hear a bee
basket-weave appearance
100
Drugs for:
Ascites:
Heart Failure:
Hypertension:
Ascites: Aldosterone antagonists (e.g., spironolactone).
Heart Failure: Loop diuretics (e.g., furosemide).
Hypertension: Thiazide diuretics (e.g., hydrochlorothiazide).
101
ACR>30 + Hypertension ----> start X
ACR>60 ------> start Y
What is X and Y
ACR>30 + Hypertension ----> start ACEi
ACR>60 ------> start ACEi
102
type 1 Resp Failure -
type 2 Resp Failure -
type 1 - 1 abnormality (low PaO2)
type 2 - 2 abnormalities (low PaO2 and high PaCO2)
103
eGFR = CAGE , what does CAGE stand for
Creatinine clearance = replace the E for what?
eGFR = CAGE (creatinine, age, gender, ethnicity)
Creatinine clearance = replace ethnicity with weight
104
Post streptococcal glomerulonephritis, electron microscopy reveals subepithelial depositions of xxx and yyy?
IgG and ↓ C3
105
UTI in Non-Pregnant Individuals
Nitro twice daily 3 days
106
UTI in 1st/2nd/3rd Trimester Pregnant
treatment
2nd line if above Ci
1st/2nd Trimester= Nitro twice daily 7 days
3rd Trimester= Nitro
2nd line if above Ci= cefalexin
107
eGFR clock main bits
108
Urinary tract infection, key bacteria
E.Coli
109
NICE Guidelines for Stopping an ACE-Inhibitor
Creatinine increases by >XXX% from baseline.
Potassium rises to ≥ YYYmmol/L, as this increases the risk of dangerous arrhythmias.
Creatinine increases by >30% from baseline.
Potassium rises to ≥6.0 mmol/L, as this increases the risk of dangerous arrhythmias.
110
Rapidly progressive glomerulonephritis
Nephritic
Crescents
Goodpasture's syndrome
ANCA-associated vasculitis
111
post-streptococcal glomerulonephritis
findings under:
immunofluorescence
electron microscopy
immunofluorescence= Starry sky appearance
electron microscopy= subepithelial deposits/ humps and bumps
112
renal cell carcinoma triad+1
haematuria
flank pain
palpable mass
PUO
113
Pyelonephritis (3)
Flank pain
Fever and chills
Leukocytes and nitrites (on urine dipstick)
114
Biliary Colic (3)
Right upper quadrant pain
Postprandial symptoms (after fatty meals)
No fever (distinguishes it from cholecystitis)
115
UTI (3)
Dysuria
Frequency and urgency
Positive leukocytes/nitrites
116
Renal Colic (3)
Loin-to-groin pain
Hematuria
Intermittent spasmodic pain
117
Appendicitis (3)
Right lower quadrant pain (McBurney's point)
Periumbilical pain migration
Rebound tenderness
Rovsing's sign +ve
118
Acute Hydrocele (3)
Tx <2 YO
Tx 2> YO
Clinical Features (3)
Scrotal swelling
**Positive transillumination**
Painless or mild discomfort
Mx:
< 2 years old: Observation (usually resolves on its own)
> 2 years old: Ligation of the patent processus vaginalis (surgical intervention)
119
Testicular Torsion (3)
Severe sudden-onset pain
Absent cremasteric reflex
High-riding testicle
120
Torsion of Testicular Appendage (3)
Blue dot sign
Localized upper pole tenderness
Normal cremasteric reflex
121
Epididymo-orchitis (3)
Tx
Scrotal pain/swelling
Positive Prehn's sign (pain relief when scrotum is lifted)
Cremasteric reflex present
STI not-suspected: Ofloxacin 400mg/day 14-DAYS (ECOLI?)
STI suspected: Ceftriaxone 500mg IM (one-off) + Doxycycline 100mg PO 14-DAYS
122
'as a general rule, teratomas more commonly occur in younger/older men,
with seminomas in younger/older men.'
tell me which one
'as a general rule, teratomas more commonly occur in younger men
with seminomas in older men.'
123
When is a nephrostomy indicated (2)
Obstructed and infected kidney (e.g., pyonephrosis)
Severe hydronephrosis to relieve pressure
124
Bladder cancer 3 buzzwords
Ix
Tx
Transitional Cell Carcinoma (TCC) - The most common histological type.
Cystoscopy - Gold standard for diagnosis.
BCG Therapy - Common intravesical treatment for non-muscle-invasive bladder cancer.
125
What is Cystoscopy gold standard Ix for?
Bladder Cancer
126
Orchitis (3 buzzwords)
✅ Mumps virus – Most common viral cause (especially in post-pubertal males)
✅ Testicular swelling – Unilateral or bilateral; tender, enlarged testis
✅ Systemic symptoms – Fever, malaise, ± parotitis (if due to mumps)
127
Cystine stones, buzzword?
Tx
Childhood
penicillamine
128
Most common stones?
Calcium Oxalate
129
Balanitis (7)
Erythema
(fungal) candidiasis (associated with intercourse - itch +/- white discharge)
bacterial (staphylococcus spp – pain, itch, yellow discharge)
Rx: Fungal= Topical clotrimazole (2wks)
bacterial=oral flucloxacillin respectively
Diabetics
– Rx topical/oral metronidazole
Definitive/recurrent= Circumcision
130
Stress incontinence - 1st Line Tx and Sx Tx
1st= pelvic floor exercises.
Surgical Tx = TOT (Transobturator Tape)
131
Urge incontinence- 1st Line Tx
2nd Line
Old people
instruction for bladder training/bladder drill
Tolterdine/ Solfencin/ Oxybutynin
Mirabegron
132
1st Line Tx BPH long term
and short term
ST Tamsulosin (a1-antagonist)
LT Finasteride (5a- reductaste inhibitor)
133
1st line Pharmacology Tx Overactive Bladder (OAB) with symptoms of urgency, frequency, and urge incontinence.
Oxybutynin
134
1st Line Tx symptomatic relief of dysuria , in UTIs.
low yield
Phenazopyridine
135
LUTS associated with BPH Tx
Tamsulosin
alpha blocker
136
Stress Urinary Incontinence (SUI) in women 2nd line
Duloxetine
137
balanoposthitis (3)
Inflammation - Redness, swelling, and irritation of the glans and foreskin.
Infection - Commonly caused by fungal (e.g., Candida) or bacterial pathogens.
Hygiene - Poor genital hygiene is a key risk factor.
138
Family Hx Kidney stones- which type? and Tx
Cystine
penicillamine
comes in kids!
139
Phimosis (1)
Non retractable foreskin
PHI-mosis = Pinned Hood In place
140
Paraphimosis (1)
trapped foreskin
141
Peyronie’s Disease (3)
Fibrous plaques
Penile curvature
Painful erections
142
Priapism (2)
unwanted erection
venous occlusion
143
Radiolucent Stones
(4)
CANT SEE IN XRAY
'**'T**ranslucent** I**n **U**r **X**ray''
Tiramterene
Indinavir (HIV)
Uric Acid
Xanthine
144
A semi-opaque stone with a 'ground-glass' appearance on X-Ray(1)
**KIDS GENETIC ONE**
cystine stone
145
Radiopaque stones (3)
struvite
calcium oxylate (TZD/ BENDRO)
calcium phosphate stones
146
treatment for acute pyelonephritis/septic
Cefalexin 500mg PO four times a day for 10–14 days.
147
Calculate Anion Gap
Anion gap = (Na + K) - (HCO−₃ + Cl )
148
Transitional Cell Carcinoma (TCC) of the Bladder (3)
painless hematuria
smoking
occupational exposure to chemicals.
NO FEVER!
149
Renal cell carcinoma (3)
Painless hematuria
flank pain
palpable mass
PUO!
150
Urge Incontinence:
What happens
You feel a sudden, strong urge to pee and can’t hold it in
trigger=
hearing running water or arriving home (key-in-the-door phenomenon).
151
Stress Incontinence:
What happens
Pee leaks out during activities that put pressure on the bladder.
When it happens: Laughing, coughing, sneezing, lifting something heavy.
152
Varicocele (4)
Bag of worms
Testicular atrophy
Infertility
Valsalva manoeuvre
153
1st Line Medical Tx for
Ureteric Stones (<10 mm):
Pain Relief: NSAIDs (e.g., diclofenac, ibuprofen) are first-line.
Facilitating Passage: Tamsulosin (α-blocker) for distal ureteric stones.
153
Tx for Minimal Change Disease (MCD)
Steroids
154
Tx epididymitis
IM Ceftriaxone and PO Doxycycline
Dox for Cox, Ceft for Test(icles).
155
Haemorrhagic cystitis Tx
(inflam of bladder lining)
cyclophosphamide
155
acute bacterial prostatitis Tx
Ofloxacin or Ciprofloxacin 28 days
156
Highs & Lows Rule" for CKD:
High what (4) PUP
Low what (3)
High: Potassium, Urea, Phosphate, PTH
Low: Calcium, Vitamin D, Erythropoietin (causing anemia)
157
Teratomas = troops = who gets it?
Seminomas= sergeants = who gets it?
Teratomas = troops = usually younger ment
Seminomas= sergeants = older (middle age)
158
RTA Type 1 → 3 things happening
Can't get rid of acid (H⁺) →
Alkaline urine →
Kidney stones
159
RTA Type 4 → 3 things happening
Aldosterone issue →
Hyperkalemia + Acidosis
160
Renal Stone <5mm Tx
💧Expectant = wait, drink fluids, let it pass on its own
161
Renal Stone 5 -10mm Tx
💥 Lithotripsy = sound waves to break the stone (shockwave lithotripsy = SWL)
low yield
162
General Stone <20mm + Pregnant 👶
Ureteroscopy (safe in pregnancy, no radiation)
163
Renal >20mm // Large/complex stone
🛠️ Percutaneous nephrolithotomy (PCNL) = keyhole surgery through the back
164
Blocked kidney or infection (e.g. hydronephrosis + fever) 🚨
ALARM!
Nephrostomy = emergency drainage tube into kidney
165
🔑 Causes of normal anion gap (hyperchloraemic) metabolic acidosis:
HARDASS
Hyperalimentation
Addison’s disease
Renal tubular acidosis
Diarrhoea ✅
Acetazolamide
Spironolactone
Saline infusion
166
HIGH AG (3)
NORMAL AG (3)
DKA, lactate, uraemia, toxins → HIGH AG
RAD
RTA, Addison’s, Diarrhoea, → NORMAL AG
167
CDI: "Desmopressin works" – Urine osmolarity same/ increases / decreases after desmopressin.
NDI: "Desmopressin doesn't work" – Urine osmolarity stays the same/ increases/decreases after desmopressin.
CDI: "Desmopressin works" – Urine osmolarity increases after desmopressin.
NDI: "Desmopressin doesn't work" – Urine osmolarity stays the same after desmopressin.
168
How long to wait to check PSA after prostate biopsy?
How long to wait to check PSA after Prostatitis?
How long to wait to check PSA after ejaculation/ heavy exercise?
Prostate biopsy: 2 months → Acceptable (6 weeks–2 months is the general range)
Prostatitis: 1 month
Ejaculation/vigorous exercise: 48 hours
169
High urea= AKI / Azotemia
170
Amyloidosis what is it?
3 buzzwords
Ix results
NEPHROTIC
Amyloidosis is a condition caused by extracellular deposition of misfolded protein fibrils (amyloid) that disrupt normal organ function, often presenting with multisystem involvement.
Macroglossia – enlarged tongue, especially in AL amyloidosis
Periorbital purpura – "raccoon eyes" bruising
Restrictive cardiomyopathy – thickened ventricular walls, diastolic failure
Congo red stain – apple-green birefringence under polarized light
171
BPH 2 zones
Transition
Peripheral
What happens in each?
Transition = BPH
Peripheral= PROSTATE CANCER
172
Prostate Cancer Ix
multiparametric MRI
173
Prostate Cancer grading?
Gleesons
174
Prostate Cancer, advanced-
Tx
Hormal Therapy
GnRH agonist (Goserelin)
175
Bladder Cancer
Age 45 or over with …
Unexplained visible haematuria without UTI OR visible haematuria that persists after successful UTI Rx
Age 60 or over with …
Visible haematuria and either dysuria or raised WCC on blood test that occurs after successful UTI Rx
Age 45 or over with …
Unexplained visible haematuria without UTI OR visible haematuria that persists after successful UTI Rx
Age 60 or over with …
Visible haematuria and either dysuria or raised WCC on blood test that occurs after successful UTI Rx
176
Bladder Cancer Ix (3)
flex cystoscopy + CT urogram + kidney/bladder-post void USS
177
Macroscopic Haematuria Investigation
Under 50
UNDER 50
Renal/Bladder USS + Flexible
cystoscopy
+/- CT urography if no cause found
178
RCC (4 buzzwords)
Painless Haematuria + Loin pain + Abdominal mass + left varicocele
179
RCC Ix
Renal USS, Triple phase CT, Biopsy
180
baby kidney tumour
nephroblastoma, wilms
181
Ependymal Cyst (3)
posterior swelling
Separate from the body of the testicle
182
cancer marker seminoma and non-seminoma
seminoma= PLAP
Non-seminoma eg teratoma = AFP/ HCG
183
MOA sildenafil (viagra)
AE?
PDE-5 Inhibitors (Sildenafil aka Viagra
BLUE PILL = BLUE VISION
184
4 Diffuse proliferative glomerulonephritis (3)
Haematuria + proteinuria + ↓C3 i.e. MIXED
lupus nephritis (Class IV)
wire-loop lesions
Anti Smith (specific)
185
Granulomatosis with Polyangiitis (GPA / Wegener’s) (3)
Granulomatosis with Polyangiitis (GPA / Wegener’s)
URT + LRT symptoms: e.g. nasal crusting, epistaxis, sinusitis, haemoptysis
May cause saddle nose deformity
cANCA+ (anti-PR3)
186
Eosinophilic Granulomatosis with Polyangiitis (EGPA / Churg-Strauss) (3)
Think asthma + eosinophilia
Late-onset asthma
pANCA+ (anti-MPO)
🧠 Mnemonic: "Churg-Strauss avoid Pork (pANCA)"
187
Microscopic Polyangiitis (MPA)
(2)
NO ENT
OR
ASTHMA FEATURES
188
Pre-renal AKI fall
Renal AKI fall
Urea:Creatinine Ratio for both
and 2 Examples for both
Pre-renal AKI, High (>20:1) U:C Dehydration, hypovolaemia
========================
Renal AKI, Normal or low U:C Rhabdomyolysis, ATN
189
Renal papillary necrosis
Renal papillary necrosis:
Frank haematuria
loin pain
proteinuria (also caused by pyelonephritis, diabetic nephropathy, obstructive nephropathy, sickle cell anaemia)
190
CKD UTI Tx
Male/Female 3a,
3b/4/5
3a= trimethoprim
3b/4/5= Pivmecillinam
Due to risk of hyperkalaemia – Trimethoprim is avoided if co-prescription of ACE-I/ARB or spironolactone
191
a rise in serum creatinine of 26 micromol/litre or greater within 48 hours
a 50% or greater rise in serum creatinine known or presumed to have occurred within the past 7 days
a fall in urine output to less than 0.5 ml/kg/hour for more than 6 hours in adults and more than
a rise in serum creatinine of 26 micromol/litre or greater within 48 hours
a 50% or greater rise in serum creatinine known or presumed to have occurred within the past 7 days
a fall in urine output to less than 0.5 ml/kg/hour for more than 6 hours in adults and more than
192
Ureteric stone <10mm
Lithotripsy +/- A-blockers
193
Ureteric stone 10-20mm
Ureteroscopy
